Quantitative and qualitative assessment of musculoskeletal disorders and socioeconomic issues of workers of brick industry in Pakistan

Brick industry, in Pakistan, is prominent and provides job to 3.1 million people only in one province. The industry hires different percentage of workers for different stages of brick formation and these stages trigger musculoskeletal disorders (MSDs) in workers. This study identifies relation between 5 work stages and MSDs in 9 body parts and also finds socioeconomic sufferings inflicted by the industry and removal of research gap at national level. We conducted both qualitative and quantitative research. 105 men and 45 women from 15 brick kilns were selected as subject. Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) sheets, Standard Nordic MSDs Questionnaire along with general questionnaire, still photography and video recording were used to carry out the study. About 96% workers involved in mixing & molding complained tiredness at end of day. Similarly, 90% male and 83% female staff performing spreading task suffered tiredness after their duty hours. Workers engaged in different tasks reported varying levels of pain in observed body parts. Digging and carrying jobs caused significant pain in body parts including neck, upper back, shoulders, lower back and hips. Mixing and molding emerged most dangerous activities for most of the body parts and exhibited 7 score on RULA. Furthermore, mixing and molding demonstrated high to very high risk level by showing 9 and 13 higher score on REBA, respectively. The current study divulged that all observed work tasks during manufacturing and transportation of bricks are equally dangerous for pain generation in lower back. Many socioeconomic issues like residency of workers in muddy house (83%) low monthly income (<90.3 $) of 83% workers, higher tendency of alcoholism and smoking in men, lack of health facilities and higher illiteracy rate were also identified. The enhanced musculoskeletal disorders during brick making process render the brick industry unhealthy for work. This dismal picture requires an improvement in quality of life and occupational environment of workers of the industry. Well organized duty timings, modified working posture, job rotation and preliminary training perhaps manage these miseries and the output of the brick industry may increase many fold.     

Risk factors analysis: Work-related musculoskeletal disorders among male traffic policemen using high-powered motorcycles

IntroductionThe occupational safety and health issues for police riders and other professional riders are often related to ergonomic hazards and risks. The purpose of this research was to identify the factors that contribute to the health effects in developing work-related musculoskeletal disorders (WMSDs) among male traffic policemen using high-powered motorcycles.Materials and methodsA cross-sectional study was conducted using 137 police riders. A set of questionnaires including the Standardised Nordic Questionnaire (SNQ) and human vibration meter (Svantek 106) was used in this study.ResultsThe prevalence of WMSDs was 67.9%. Multiple logistic regression analysis revealed that the duration of riding a motorcycle (OR = 0.175, 95% CI:0.052, 0.581), years of service (OR = 0.152, 95% CI: 0.040, 0.567), and hand-arm vibration, HAV (OR = 3.053, 95% CI: 1.126, 8.280) were significant risk factors for the prevalence of WMSDs.DiscussionThe majority of riders reported symptoms of WMSDs within the past 12 months. Riding duration, years of service, and hand-arm vibration (HAV) were found to be the most important risk factors for WMSDs in this rider group. The results highlight that in the context of ergonomic interaction, high-powered motorcycles and the police riders are not a good fit. Hence, further study is needed to improve the safety and health of the police riders.     

Risk of neck musculoskeletal disorders among males and females in lifting exertions

Work-related neck disorders are common among various occupational groups. Despite clear epidemiological evidence for the association of these disorders with forceful arm exertions, the effect of such exertions on the biomechanical behavior of the neck muscles is currently not well understood. In this study, the effect of lifting tasks on the biomechanical loading of neck muscles was investigated for males and females. Twenty-six participants (13 males and 13 females) performed bi-manual isometric lifting tasks at knuckle, elbow, shoulder, and overhead heights by exerting 25%, 50%, and 75% of their maximum strength. The activity of the cervical trapezius and sternocleidomastoid muscles was recorded bilaterally using surface electromyography. Higher activity of the cervical trapezius muscle (10% MVC–43% MVC) compared to the sternocleidomastoid muscle (4% MVC–18% MVC) was observed. Females tend to use the sternocleidomastoid muscle to a greater extent than males, whereas, higher cervical trapezius muscle activation was observed for males than females. The main effect of weight and height, and weight by height interaction on the activity of neck muscles was statistically significant (all p < 0.001). The results of this study demonstrate that the neck muscles play an active role during lifting activities and may influence development of musculoskeletal disorders due to resulting physiological changes.     

Bernardino Ramazzini's early observations of the link between musculoskeletal disorders and ergonomic factors

Bernardino Ramazzini (1633-1714) systematically studied the relationship between work and diseases. He realized that it was not possible to ascribe all workers' diseases to chemicals or physical agents and foresaw that other factors were involved. He observed that common diseases could originate following the maintenance either of prolonged stationary postures or of unnatural postures (e.g. bakers, workers who stand, sedentary worker, scribes, weavers) or following activities requiring heavy muscular performance (e.g. porters and woodworkers). Furthermore, Ramazzini recognized the need to undertake measures to prevent disorders from repetitive motions and manual lifting and anticipated the now accepted advice of moderation and recommendations of reduction of work duration for a number of hard jobs requiring a standing position or severe muscular effort. From his early writings therefore it is evident that Ramazzini realized the importance of assessing the ergonomic factors associated with the occurrence of work-related musculoskeletal disorders.     

Comparison of posture and muscle control pattern between male and female computer users with musculoskeletal symptoms

The primary purpose of this study was to compare the posture and muscle control patterns between male and female computer users with musculoskeletal symptoms. Forty computer users were recruited. Each subject performed a preferred speed typing, a fast speed typing, and a repetitive mouse task. The independent variables were gender, typing speed, and time. There were significant differences between genders for head and neck flexion angles when they were performing the preferred speed typing task. Significant differences between genders were also found for upper extremity angles when they were performing the repetitive mouse task. Male computer users had a smaller root mean square of the right extensor digitorium than females. In general, postural differences were significant between genders, even when the subjects' table and chair were adjusted to meet their anthropometry. Our results suggest that modifications of the computer working environment may be different between genders.     

Need for recovery among male technical distal on-call workers

The objectives of this study were to (1) examine whether need for recovery differs between workers (i) not on-call, (ii) on-call but not called and (iii) on-call and called, and (2) investigate the associations between age, health, work and social characteristics with need for recovery for the three scenarios (i–iii). Cross-sectional data of N = 169 Dutch distal on-call workers were analysed with multivariate logistic regression. Need for recovery differed significantly between the three scenarios (i–iii), with lowest need for recovery for scenario (i) ‘not on-call’ and highest need for recovery for scenario (iii) ‘on-call and called’. Poor mental health and high work–family interference were associated with higher need for recovery in all three scenarios (i–iii), whereas high work demands was only associated with being on-call (ii and iii). The results suggest that the mere possibility of being called affects the need for recovery, especially in workers reporting poor mental health, high-work demands and work–family interference.     

The investigation of work-related musculoskeletal disorders among female workers in a hazelnut factory: Prevalence,working posture,work-related and psychosocial factors

BackgroundWork-related musculoskeletal disorders (WMSDs) are the most common occupational health problems in the industrialized world. The identification of WMSDs specific to occupation is essential to plan and implement preventative programs. This study investigated the prevalence of WMSDs and determined the factors related to the severity of the most common disorders among female workers in a hazelnut factory.MethodsA total of 114 female workers were examined in this cross-sectional study using the Nordic Musculoskeletal Questionnaire, the Dutch Musculoskeletal Questionnaire, and an author-developed questionnaire (for socio-demographic characteristics and psychosocial factors). Working posture, craniovertebral angle, thoracic kyphosis angle (TKA), and lumbar lordosis angle were evaluated based on a photogrammetry method using the ImageJ program.ResultsThe prevalence of WMSDs in at least one body part during the last 12 months was 92.1%. The highest prevalence of WMSDs was in the lower back (61.4%), neck (57.9%), shoulder (53.6%), and upper back (45.6%). The least affected part was the elbow. Lower back, shoulder, and neck disorders were the most common causes of activity limitation. The severity of lower back pain was associated with stress in the workplace and work-related factors. The neck pain severity was related to craniovertebral angle and work-related factors. The shoulder pain severity increased with TKA and employment duration. TKA was related to upper back pain severity.ConclusionsWMSDs are common among female workers in a hazelnut factory. Reorganizing of working posture, work-related factors, and stress at work may be beneficial to decrease the prevalence of WMSDs and pain severity.Relevance to Industry; The female workers in the hazelnut factory are vulnerable to the work-related musculoskeletal disorders, particularly in the spinal region. The employers should endeavor to improve the health of the workers by the adjustment of the working posture and environmental factors.     

Heavy load carrying and musculoskeletal health: An exploratory study of biomechanical risk factors among sand miners in Pokhara,Kaski District,Nepal

BackgroundTrends in urbanization contribute to the growing global demand for raw construction materials. The health effects of load carrying among occupational groups that mine and carry sand and stone used for construction of roads and buildings remains poorly understood.MethodsWe conducted an exploratory cross-sectional study among a convenience sample of sand miners working at an excavation site on the Seti River in Pokhara, Nepal. Load carrying weight, duration, and frequency were used to categorize miners as having “low” or “high” load-carrying exposures. Musculoskeletal disorders (MSDs) were identified using self-reported symptoms of moderate to severe musculoskeletal pain, as well as physical examinations.ResultsThe average loads carried by female and male sand miners weighed 66 kg and 87 kg, respectively. Among all participants (N = 42), 45% reported moderate to severe musculoskeletal pain in at least one body region and 16 (38%) had MSDs identified using specified case criteria. The prevalence of MSDs was lower among miners carrying, on average, heavier loads compared to those carrying lighter loads (OR = 0.18; 95% CI: 0.04, 0.7), possibly indicative of the healthy worker survival effect. Miners carrying loads for longer durations had higher odds of MSDs compared with those carrying for shorter durations.ConclusionThis study has provided data on the extraordinary loads carried by sand miners in Nepal and preliminary evidence of health impacts associated with these loads. However, larger epidemiologic studies are needed to justify action to protect the health and safety of these unrecognized and understudied groups.     

Road traffic offending,stress, age,and accident history among male and female drivers

This paper draws on data gathered during a larger study of driving behaviour to explore possible connections between stress, offending against the traffic laws, and accident rates, and gives particular attention to comparisons between male and female drivers. Data were gathered from 422 drivers by a postal questionnaire, and further measures of stress were obtained during semi-structured interviews with a specially selected subset of 66 of them. Analyses of variance investigated links between offending rates, accident history, and up to seven measures of stress, taking age and gender into account. In the results accident history, although positively related to offending, played little part in links involving stress variables. The principal findings were that (a) stress, both on and off the road, was positively associated with offending among both male and female drivers, and (b) although females overall offended less than males, females experienced more stress than males whatever their level of offending. One possible interpretation of these results is suggested by the feminist literature, which could account for both the higher levels of stress and lower levels of offending found among women drivers. However, there is unlikely to be a clear-cut gender divide in offending-stress relationships, and some small groups of female drivers in the study behaved like male ones. It is suggested that people's driving reflects their lifestyles, and that women drivers' patterns of offending and stress will resemble those of male drivers to the extend that their lives and concerns are similar to men's. It is concluded that this proposition warrants further research.     

Interventions for increasing male and female undergraduate interest in information technology

There is a continuing worldwide need for developing a larger and more diverse workforce in the broad field of information technology (IT). We report on two activities conducted by the project within selected classes of a postsecondary finite mathematics course: 1) a student-written blog about practical applications of computing, and 2) after-class seminar sessions with professionals about the importance of computing in the work world. It was found that the hundreds of students who actively participated in these activities were significantly more likely to enroll in a computing course or declare a computing-related major than were non-participating students, despite the fact that the two groups of students displayed identical attitudes toward computing at the start of the term. The study demonstrates that relevant blogs and sessions with professionals can be effective tools for recruiting students, including women, who otherwise would not have chosen to complete more course work in computing.     

Musculoskeletal disorders among female and male air traffic controllers performing identical and demanding computer work

Operators with identical, demanding computer work (90 female and 97 male air traffic controllers) were found to have high prevalences of disorders (assessed by questionnaire and physical examination) in neck, shoulders and upper back. In spite of the identical work, the women displayed higher prevalences than the men (e.g. neck diagnoses 21% vs. 4%). Disorders in elbows, wrists and hands were less common, with similar rates in both genders. Generally, the psychosocial work environment (assessed by questionnaire) was found to be good, but with large inter-individual variation. Women experienced lower decision latitude than men, particularly regarding influence and freedom at work, but perceived higher social support. Physically, the work was characterized by relatively low angular velocities of upper arms (measured by inclinometry) and wrists (right: <1°/s during 19% of time, measuring by goniometry), dynamic muscular activities and high time fractions of rest in the trapezius and forearm extensor muscles (measuring by electromyography). There were only minor differences between the genders.     

Physical discomfort and psychosocial job stress among male and female operators at telecommunication call centers in Taiwan

The prevalence of job stress, distributions of major job stressors, and associations between perceived job stress levels and multiple physical discomforts are assessed via a cross-sectional study of 1023 male and female operators at telecommunication call centers in Taiwan. Cases of discomfort are identified via questionnaire surveys requiring respondents to self-reported symptoms of discomfort. Information is obtained on demographics, health status, perceived job stress levels, major job stressors and psychosocial job characteristics. Multivariate logistic regression models are developed to predict physical discomfort in nine body areas. ‘Eye strain’, ‘hoarse or painful throat’ and ‘musculoskeletal discomfort’ are the most pronounced and prevalent complaints after prolonged work time at call centers. Female operators had higher prevalence of physical discomfort than male operators for all body areas. ‘Encountering difficult customers’ ranked as the most important job stress factor among both male and female operators. Working in a call center for more than 4 years is strongly associated with discomfort in all body areas (odds ratio ranges from 1.65 to 2.15). Analysis of risk factors vs. physical discomfort reveals that operators who perceive higher job stress have significantly increased risk of several health complaints, including eye strain, tinnitus, hoarse or painful throat, chronic cough with phlegm, chest tightness, irritable stomach or peptic ulcers, frequent urination and musculoskeletal discomfort.     

Muscular fatigue and maximum endurance time assessment for male and female industrial workers

A single arm pushing experiment was conducted in an electronic factory in Yantai, China to assess muscular fatigue using the theoretical models of muscular strength and maximum endurance time (MET) developed by Ma et al. (2009). Seventy seven workers, including 38 males and 39 females, participated in the study. The muscular strength of pushing was measured after the subject pushed a stick, with a force of 2.5 kgf, for 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 min. Fatigue rate was determined based on a regression approach. In addition to the theoretical model, the MET for such a pushing task was also determined using four empirical models in the literature. The results indicated that females were more resistant to muscular fatigue than males in the pushing task. The results of the muscular strength prediction show that the predictability of the muscular strength model is acceptable. The prediction errors for muscular strength for female subjects were significantly lower than those of the male subjects. The predicted MET using the theoretical model, with a group constant k, was highly correlated with those using the empirical models compared in the current study.     

DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers: a validity and reliability study

Purpose

The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The aim of this study was to evaluate the reliability and the construct validity of the DASH questionnaire by establishing its correlation to the Medical Outcomes Study Short Form-36 (SF-36) in industry workers. Also we aimed to investigate whether the DASH can be used as a standardized questionnaire to evaluate the work-related musculoskeletal disorders (WMSDs) in upper extremity in industrial settings and epidemiological studies.

Material and methods

The Turkish version's reliability and construct validity were evaluated in 240 industry workers with upper-extremity musculoskeletal complaints. Workers were asked to complete a packet that included the DASH and the SF-36. Test-retest reliability was assessed in all workers who filled in the DASH questionnaire 15 days later. Construct validity was evaluated by comparing the overall and work component DASH scores with SF-36 summary and subscales.

Results

The mean DASH score for the textile workers whose duties were confection, dyeing, sewing, quality control and packaging was calculated as 65, 55, 68, 54 and 67, respectively. As a result of this study, pain intensity in shoulder, wrist and hand was significantly associated with the DASH score (p<0.05). Internal consistency of the DASH was high (Cronbach alpha 0.91). Test-retest reliability was excellent for the overall DASH (intraclass correlation coefficient (ICC) 0.92). Moderate correlations (p<0.05) were found between the overall and work component DASH and the SF-36 summary scales. Pearson correlation coefficients of the overall and work component DASH to the SF-36 subscales ranged from −0.33 to −0.82.

Conclusion

These results support that DASH is a reliable and valid instrument to measure functional disability and investigate the ergonomic risk factors in textile workers with upper-extremity musculoskeletal complaints.     

Development of an injury prevention model for playing-related musculoskeletal disorders in orchestra musicians based on predisposing risk factors

IntroductionPlaying an instrument could lead to various disorders and several musicians report problems during their career. As there is no existing one, the aim of this study was to build a comprehensive model of injury prevention and risk factors in musicians by combining literature with interviews of musicians and experts.MethodsThe initial model has been based on literature. This model identified nine categories of risk factors. Then, interviews were conducted with 15 Royal Liverpool Philharmonic Orchestra musicians and 9 experts in musicians’ health to develop the final version.ResultsEighty percent of the RLPO instrumentalists experienced at least once PRMDs in their career. Postural and workload issues were mentioned most frequently. Experts agreed broadly with the initial model and added interesting items that should be taken into account in assessing musicians’ health.DiscussionThis theoretical framework provides perspectives in terms of assessment, treatment and prevention in musicians, whether they are currently suffering from PRMDs or not.     

Personal predictors of the longest episode of occupational sitting and their interaction with workplace support for health among workers in Accra: A cross-sectional analysis with sensitivity analyses

Many studies have identified personal factors associated with occupational sitting time, but none of them focused on the longest episode of occupational sitting (hereby referred to as continuous occupational sitting time) nor considered whether workplace support for health moderates the associations between these factors and continuous occupational sitting time. This study aimed to identify personal factors predicting continuous occupational sitting time and ascertained whether workplace support for health moderates the associations between these factors and continuous occupational sitting time. A cross-sectional design and an adapted hierarchical linear regression analysis was employed. The participants were 991 employees of public and private organizations in Accra, Ghana. Results were presented with hierarchical linear regression analysis. The ultimate predictors of continuous occupational sitting time at a minimum of p < 0.05 include age, job type, and job income. Workplace support for health significantly moderated the primary associations, which means that workplace support for health altered the strength of the associations between all predictors (except tenure) and continuous occupational sitting time. This study concludes that there are inequalities in continuous occupational sitting time between employee groups that can be modified by workplace support for health.     

A case study of Taiwanese custom-beverage workers for their musculoskeletal disorders symptoms and wrist movements during shaking task

This study administered the Nordic Musculoskeletal Questionnaire to a convenience sample of 106 workers at custom-beverage vendors in Taiwan (who prepare drinks through manual shaking) to explore their work-related musculoskeletal disorders (WMSDs) and identify risk factors for these disorders symptoms. Wrist posture for twenty workers were also measured for three shaking methods using an electrogoniometer. The prevalence of musculoskeletal discomfort in the past year among the respondents was 88.6%. Most of them reported discomfort in their hands/wrists (67.9%), followed by the lower back/waist (44.3%), knees (39.6%), and shoulders (38.7%). Hands/wrists and low back/waist discomforts varied significantly by the worker's gender and the number of working days per week, and hands/wrists discomfort also by the shaking method. Knee discomfort was affected by age and whether rest periods at work were scheduled, whereas shoulder discomfort by work experience, number of working days per week, and number of drink orders prepared per day. Measurements in wrist postures exhibited that repetitive activity for each wrist was as high as 4 time/s for a cup preparation (10 s). Among shaking methods, curve swing can constrain the shakers' wrists in a relatively neutral position and a smaller range of movement than others, regardless of the sex.Relevance to industryBecause of the nature of shaking-based beverage preparation work, the respondents have a higher prevalence of discomfort in the hands/wrists, lower back/waist, knees, and legs/ankles than their counterparts in other industries. These findings are expected to inform the prevention and alleviation of musculoskeletal discomfort in custom-beverage workers.     

State of worksite health promotion in companies with and without Quality‐Management systems: A comparative study

The goal of comprehensive worksite health promotion (WHP) is to protect and promote the health and performance of employees. WHP principles link health‐promotion activities to existing management systems, such as Quality Management (QM), to better integrate these activities into goals and processes of the company. Accordingly, it was hypothesized that the presence of a QM system is related to increased institutionalization and scope of WHP. Swiss companies in the service sector with a certified QM system (N = 289) were compared to a random sample of service‐sector companies without QM systems (N = 334). The results show that the presence of a certified QM system is related to the quality of WHP, as companies have both a stronger institutionalization and a broader scope of WHP compared to companies without a certified QM system. The present study produced empirical evidence that QM systems might be an enhancing factor for WHP. © 2010 Wiley Periodicals, Inc.     

Risk analysis for occupational safety and health in the textile industry: Integration of FMEA,FTA, and BIFPET methods

Identifying and managing health and safety risks that threaten personnel in production systems are vital for the continuity and success of organizations. Many tools are used to accurately analyze and assess risks. Failure mode and effect analysis (FMEA) is one of the most commonly used tools in different industries. However, the accuracy and reliability of FMEA method have been fairly criticized by many researchers in the field. In this study, an approach based on FMEA that integrates the advantages of the fault tree analysis (FTA) method and belief in fuzzy probability estimations of time (BIFPET) algorithm has been proposed in order to improve the performance of the FMEA method. In order to practically apply the proposed method to real life problems, it has been employed to analyze and assess the potential risks for a finishing process in the fabric dyeing department of a textile company. The performance of the proposed FMEA-FTA-BIFPET method has been compared to the results obtained by FMEA-FTA and FMEA-FTA-program evaluation and review technique (PERT) distribution integrated methods. The results of this study show that failure related to fabric trimming adjustment in the tenter has the highest risk priority number. The proposed approach can be used in various industry for risk analysis. In addition, results obtained by the study have indicated that the proposed approach can be implemented in practice to perform comprehensive risk assessment procedures as it reflects real-life dynamics to analyze and assess potential risk.